Provider Demographics
NPI:1306475652
Name:VAZQUEZ, YULIESVY (APRN)
Entity type:Individual
Prefix:
First Name:YULIESVY
Middle Name:
Last Name:VAZQUEZ
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3441 TORREMOLINOS AVE
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33178-2965
Mailing Address - Country:US
Mailing Address - Phone:305-560-9654
Mailing Address - Fax:
Practice Address - Street 1:10560 NW 27TH ST STE 101
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33172-5928
Practice Address - Country:US
Practice Address - Phone:305-776-0138
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-07
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11006736363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty